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= Vidhi Vimarsha (Applied Inferences) =
== Vidhi Vimarsha (Applied Inferences) ==
== Diagnostic codes==
=== Diagnostic codes===
National Ayurveda Morbidity Code: EA-3
National Ayurveda Morbidity Code: EA-3<ref>Avaialable from http://namstp.ayush.gov.in/#/Ayurveda accessed on 10/06/2021</ref>
ICD code: R05
ICD code: R05
== Causes of kasa ==
=== Causes of kasa ===
'''Dietary:'''
'''Dietary:'''
*Entry of food into respiratory tract [Su.Sa.Uttara Sthana 52/4]<ref name= Susruta> Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref>
*Entry of food into respiratory tract [Su.Sa.Uttara Sthana 52/4]<ref name= Susruta> Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref>
==Classification==
===Classification===
#[[Vata]][[dosha]] predominance
#[[Vata]] [[dosha]] predominance
#[[Pitta]][[dosha]] predominance
#[[Pitta]] [[dosha]] predominance
#[[Kapha]][[dosha]] predominance
#[[Kapha]] [[dosha]] predominance
#Traumatic injury (kshataja)
#Traumatic injury (kshataja)
#Depletion of body tissues (kshayaja) [Cha.Sa.[[Chikitsa Sthana]] 18/3-4]
#Depletion of body tissues (kshayaja) [Cha.Sa.[[Chikitsa Sthana]] 18/3-4]
==Premonitory features==
===Premonitory features===
*Thorny feeling in mouth and throat
*Thorny feeling in mouth and throat
*Low digestive capacity [Su.Sa.Uttara Sthana 52/7]<ref name=Susruta/>
*Low digestive capacity [Su.Sa.Uttara Sthana 52/7]<ref name=Susruta/>
==Clinical features==
===Clinical features===
===General clinical features===
====General clinical features====
The voice of patient resembles the sound that comes out of a broken bronze vessel. [Su.Sa.Uttara Sthana 52/5]<ref name=Susruta/>
The voice of patient resembles the sound that comes out of a broken bronze vessel. [Su.Sa.Uttara Sthana 52/5]<ref name=Susruta/>
===[[Dosha]] specific clinical features===
====[[Dosha]] specific clinical features====
====[[Vata]] dominant kasa====
======[[Vata]] dominant kasa======
*Excruciating pain in the epigastric region, flanks, chest, and head
*Excruciating pain in the epigastric region, flanks, chest, and head
*Increases after digestion of food [Cha.Sa.[[Chikitsa Sthana]] 18/10-13]
*Increases after digestion of food [Cha.Sa.[[Chikitsa Sthana]] 18/10-13]
====[[Pitta]] dominant kasa====
======[[Pitta]] dominant kasa======
*Yellowish sputum and eyes
*Yellowish sputum and eyes
*Expectoration of sputum mixed with [[pitta]] [Cha.Sa.[[Chikitsa Sthana]] 15-16]
*Expectoration of sputum mixed with [[pitta]] [Cha.Sa.[[Chikitsa Sthana]] 15-16]
====[[Kapha]] dominant kasa====
======[[Kapha]] dominant kasa======
*Poor digestion
*Poor digestion
*Feeling of fullness in the chest [Cha.Sa.[[Chikitsa Sthana]] 18/18-19]
*Feeling of fullness in the chest [Cha.Sa.[[Chikitsa Sthana]] 18/18-19]
In a study, [[kapha]]kasa is compared with chronic bronchitis.<ref name=shilpals>Shilpa L.S., Prashanth A.S. A Critical Review on the Etiopathogenesis and Treatment of KaphajaKasa (Chronic Bronchitis). J Ayurveda Integr Med Sci 2016;4:118-122. http://dx.doi.org/10.21760/jaims.v1i4.6928</ref>
In a study, [[kapha]]kasa is compared with chronic bronchitis.<ref name=shilpals>Shilpa L.S., Prashanth A.S. A Critical Review on the Etiopathogenesis and Treatment of Kaphaja Kasa (Chronic Bronchitis). J Ayurveda Integr Med Sci 2016;4:118-122. http://dx.doi.org/10.21760/jaims.v1i4.6928</ref>
====Kasa as a result of trauma (kshataja)====
====== Kasa as a result of trauma (kshataja)======
*Initial dry cough followed by blood-tinged sputum
*Initial dry cough followed by blood-tinged sputum
*While coughing, sounds humming like a pigeon. [Cha.Sa.[[Chikitsa Sthana]] 18/20-23]
*While coughing, sounds humming like a pigeon. [Cha.Sa.[[Chikitsa Sthana]] 18/20-23]
====Kasa due to depletion of body tissues (kshayaja)====
======Kasa due to depletion of body tissues (kshayaja)======
*Expectoration of greenish, reddish sputum, associated with pus and bad odor.
*Expectoration of greenish, reddish sputum, associated with pus and bad odor.
*Frequent hard or loose stools without apparent cause [Cha.Sa.[[Chikitsa Sthana]] 18/25-28]
*Frequent hard or loose stools without apparent cause [Cha.Sa.[[Chikitsa Sthana]] 18/25-28]
==Pathogenesis==
===Pathogenesis===
[[File:Kasa_Samprapti.JPG|500px|'''Image 1: Samprapti of Kasa'''|thumb]]
[[File:Kasa_Samprapti.JPG|500px|'''Image 1: Samprapti of Kasa'''|thumb]]
*Type of pathogenesis: Obstruction (sanga), Movement of [[dosha]] in the wrong direction (vimargagamana)[Cha.Sa.[[Chikitsa Sthana]] 18/6-8]
*Type of pathogenesis: Obstruction (sanga), Movement of [[dosha]] in the wrong direction (vimargagamana)[Cha.Sa.[[Chikitsa Sthana]] 18/6-8]
==Clinical examination==
===Clinical examination===
*Respiratory rate
*Respiratory rate
*Chest examination by auscultation, palpation and percussion
*Chest examination by auscultation, palpation and percussion
==Investigations==
===Investigations===
'''Radiological examinations:'''
'''Radiological examinations:'''
*Absolute Eosinophil count
*Absolute Eosinophil count
==Prognosis==
===Prognosis===
*[[Vata]], [[pitta]] and [[kapha]] dominant kasa are curable.
*[[Vata]], [[pitta]] and [[kapha]] dominant kasa are curable.
If the patient is weak, cough due to depletion of body tissues (kshayaja kasa) may cause death. All types are palliable in old patients.[Cha.Sa.[[Chikitsa Sthana]] 18/29-30]
If the patient is weak, cough due to depletion of body tissues (kshayaja kasa) may cause death. All types are palliable in old patients.[Cha.Sa.[[Chikitsa Sthana]] 18/29-30]
==Management==
===Management===
===Principles of management===
====Principles of management====
*Avoidance of etiological factors
*Avoidance of etiological factors
*Disease-specific rejuvenation treatment (vyadhiahara [[rasayana]])
*Disease-specific rejuvenation treatment (vyadhiahara [[rasayana]])
===[[Dosha]] specific treatment principles===
====[[Dosha]] specific treatment principles====
====[[Vata]] predominance====
======[[Vata]] predominance======
*Unctuous therapies ([[snehana]])
*Unctuous therapies ([[snehana]])
*In association [[kapha]] or [[pitta]], [[dosha]]-specific measures shall be used. [Cha.Sa.[[Chikitsa Sthana]] 18/132] When [[vata]] dominant kasa is associated with [[pitta]], medicated ghee and milk after food is indicated. [A.Hr.Chikitsa Sthana 3/2]<ref name= Hridaya > Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref>
*In association [[kapha]] or [[pitta]], [[dosha]]-specific measures shall be used. [Cha.Sa.[[Chikitsa Sthana]] 18/132] When [[vata]] dominant kasa is associated with [[pitta]], medicated ghee and milk after food is indicated. [A.Hr.Chikitsa Sthana 3/2]<ref name= Hridaya > Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref>
====[[Pitta]] predominance====
======[[Pitta]] predominance======
*Therapeutic purgation ([[virechana]]) [Cha.Sa.[[Chikitsa Sthana]] 18/85]
*Therapeutic purgation ([[virechana]]) [Cha.Sa.[[Chikitsa Sthana]] 18/85]
*Unctuous electuaries [Cha.Sa.[[Chikitsa Sthana]] 18/86]
*Unctuous electuaries [Cha.Sa.[[Chikitsa Sthana]] 18/86]
====[[Kapha]] predominance====
======[[Kapha]] predominance======
*Therapeutic emesis ([[vamana]]) [Cha.Sa.[[Chikitsa Sthana]] 18/108]
*Therapeutic emesis ([[vamana]]) [Cha.Sa.[[Chikitsa Sthana]] 18/108]
*The oil exuding out from burning log of Cedrus deodara (devadaru) is used in treatment. It is mixed with powders of Piper longum, Piper nigrum and Zingiber officinale (trikatu), and ash of Hordeum vulgare (yavakshara) as a first line of treatment. [A.Hr.Chikitsa Sthana 3/41]<ref name=Hridaya/>
*The oil exuding out from burning log of Cedrus deodara (devadaru) is used in treatment. It is mixed with powders of Piper longum, Piper nigrum and Zingiber officinale (trikatu), and ash of Hordeum vulgare (yavakshara) as a first line of treatment. [A.Hr.Chikitsa Sthana 3/41]<ref name=Hridaya/>
===Disease-specific treatment principles===
====Disease-specific treatment principles====
=====Cough due to traumatic injury =====
*This acute condition should be treated immediately with drugs promoting strength and improving muscle tissues ([[mamsa dhatu]]). Sweet and life-promoting (jivaniya) drugs shall be used. [Cha.Sa.[[Chikitsa Sthana]] 18/134]
*This acute condition should be treated immediately with drugs promoting strength and improving muscle tissues ([[mamsa dhatu]]). Sweet and life-promoting (jivaniya) drugs shall be used. [Cha.Sa.[[Chikitsa Sthana]] 18/134]
*In case of stiffness of body, ghee in larger quantity should be given.[Cha.Sa.[[Chikitsa Sthana]] 18/139-143]
*In case of stiffness of body, ghee in larger quantity should be given.[Cha.Sa.[[Chikitsa Sthana]] 18/139-143]
===== Cough due to depletion of body tissues or degenerative conditions =====
In the initial stage, nourishing therapy ([[brimhana]]) with [[deepana]] (therapies that increase digestive capacity) should be given. [Cha.Sa.[[Chikitsa Sthana]] 18/150] These therapies and purification therapies (srotoshodana) shall be done alternatively. As all three [[dosha]]s are vitiated in this type of kasa, the therapies aim to pacify and balance all three [[dosha]]s. [Cha.Sa.[[Chikitsa Sthana]] 18/187-88]
In the initial stage, nourishing therapy ([[brimhana]]) with [[deepana]] (therapies that increase digestive capacity) should be given. [Cha.Sa.[[Chikitsa Sthana]] 18/150] These therapies and purification therapies (srotoshodana) shall be done alternatively. As all three [[dosha]]s are vitiated in this type of kasa, the therapies aim to pacify and balance all three [[dosha]]s. [Cha.Sa.[[Chikitsa Sthana]] 18/187-88]
If kasa is associated with discoloration or difficulty in urination, then milk processed with Pueraria tuberose (vidari), Neolamarckia cadamba (kadamba) or with tender fruits of Flacourita jangomas (tall) should be given. [Cha.Sa.[[Chikitsa Sthana]] 18/153-54]
If kasa is associated with discoloration or difficulty in urination, then milk processed with Pueraria tuberose (vidari), Neolamarckia cadamba (kadamba) or with tender fruits of Flacourita jangomas (tall) should be given. [Cha.Sa.[[Chikitsa Sthana]] 18/153-54]
===[[Panchakarma]] procedures with safety precautions===
==== [[Panchakarma]] procedures with safety precautions ====
*Internal administration of unctuous substances (snehapana): In [[vata]]kasa [Cha.Sa.[[Chikitsa Sthana]] 18/32-33]
*Internal administration of unctuous substances (snehapana): In [[vata]]kasa [Cha.Sa.[[Chikitsa Sthana]] 18/32-33]
*Medicated unctuous enema (anuvasana [[basti]]): Medicated unctuous enema (anuvasana) is advised if pain and swelling in loin, groin, anus or penile region are present in kasa (due to depletion of body tissue) patient. [Cha.Sa.[[Chikitsa Sthana]] 18/155]. It is indicated in [[vata]] dominant kasa. [Su.Sa.Uttara Sthana 52/27]<ref name=Susruta/>
*Medicated unctuous enema (anuvasana [[basti]]): Medicated unctuous enema (anuvasana) is advised if pain and swelling in loin, groin, anus or penile region are present in kasa (due to depletion of body tissue) patient. [Cha.Sa.[[Chikitsa Sthana]] 18/155]. It is indicated in [[vata]] dominant kasa. [Su.Sa.Uttara Sthana 52/27]<ref name=Susruta/>
===Medicines used in current practice===
====Medicines used in current practice====
=====Herbs=====
Piper longam (pippali), Piper nigrum (maricha), Flacourtia jangomas (talisapatra), Solanum virginianum (kantakari), Inula racemosa (pushkaramula).<ref name=Ranades>Ranade S. Pranavaha srotas (Respiratory sysytem). In: Kayachikitsa Vol 2. Delhi: Chaukhamba Sanskrit pratishthan; 2014: 212-24</ref>
Piper longam (pippali), Piper nigrum (maricha), Flacourtia jangomas (talisapatra), Solanum virginianum (kantakari), Inula racemosa (pushkaramula).<ref name=Ranades>Ranade S. Pranavaha srotas (Respiratory sysytem). In: Kayachikitsa Vol 2. Delhi: Chaukhamba Sanskrit pratishthan; 2014: 212-24</ref>
=====Herbal formulations=====
Agastya Haritaki [Cha.Sa.[[Chikitsa Sthana]] 18/ 57-62], Kushmandarasayana [A.Hr.Chikitsa Sthana 3/114-117]<ref name=Hridaya/>, Vyaghriharitaki [B.R.15/169-172]<ref name=Ratnavali> Govindadas. Bhaishajyaratnavali. Translated from Sanskrit by Kanjiv Lochan. Reprint. Varanasi: Chaukhambha Sanskrit sansthan;2008.</ref>, Talisadichurna [B.R 15/36-40]<ref name=Ratnavali/>, Vasa arishta<ref name=shilpals/>, Vasa avaleha [B.R.15/179-181]<ref name=Ratnavali/>, Sitopaladi churna<ref name=shilpals/>, Lavangadivati [B.R.15/35]<ref name=Ratnavali/>, Khadiradi vati<ref name=Ranades/>, Kanakasava.<ref name=Ranades/>
Agastya Haritaki [Cha.Sa.[[Chikitsa Sthana]] 18/ 57-62], Kushmandarasayana [A.Hr.Chikitsa Sthana 3/114-117]<ref name=Hridaya/>, Vyaghriharitaki [B.R.15/169-172]<ref name=Ratnavali> Govindadas. Bhaishajyaratnavali. Translated from Sanskrit by Kanjiv Lochan. Reprint. Varanasi: Chaukhambha Sanskrit sansthan;2008.</ref>, Talisadichurna [B.R 15/36-40]<ref name=Ratnavali/>, Vasa arishta<ref name=shilpals/>, Vasa avaleha [B.R.15/179-181]<ref name=Ratnavali/>, Sitopaladi churna<ref name=shilpals/>, Lavangadivati [B.R.15/35]<ref name=Ratnavali/>, Khadiradi vati<ref name=Ranades/>, Kanakasava.<ref name=Ranades/>
=====Herbo-mineral formulations=====
Laxmivilasa rasa [B.R 15/130-37]<ref name=Ratnavali/>, Kasakuthara rasa, Svachandabhairava rasa<ref name=shilpals/>, Hema garbha potalirasa<ref name=shilpals/>, Rudraparpati, Bhutankusha rasa<ref name=Ranades/>, Amritarnava rasa[B.R 15/60-61]<ref name=Ratnavali/>
Laxmivilasa rasa [B.R 15/130-37]<ref name=Ratnavali/>, Kasakuthara rasa, Svachandabhairava rasa<ref name=shilpals/>, Hema garbha potalirasa<ref name=shilpals/>, Rudraparpati, Bhutankusha rasa<ref name=Ranades/>, Amritarnava rasa[B.R 15/60-61]<ref name=Ratnavali/>
===Wholesome diet===
====Wholesome diet====
Meat soup along with wheat, barley, rice etc. and sweet, sour and salty foods are wholesome in kasa with [[vata]] predominance.[Cha.Sa.[[Chikitsa Sthana]] 18/76-82]
Meat soup along with wheat, barley, rice etc. and sweet, sour and salty foods are wholesome in kasa with [[vata]] predominance.[Cha.Sa.[[Chikitsa Sthana]] 18/76-82]
Goat’s milk is good in all types of kasa.<ref name=shilpals/>
Goat’s milk is good in all types of kasa.<ref name=shilpals/>
==Complications==
===Complications===
If kasa is not appropriately treated, it leads to consumption (rajayakshma) due to aggravation of all three [[dosha]] and depletion of body tissues.[Su.Sa.Uttara Sthana 52/6]<ref name=Susruta/>
If kasa is not appropriately treated, it leads to consumption (rajayakshma) due to aggravation of all three [[dosha]] and depletion of body tissues.[Su.Sa.Uttara Sthana 52/6]<ref name=Susruta/>
==Contemporary views==
===Contemporary views===
===Case reports===
====Case reports====
=====Solanum xanthocarpum=====
The whole plant (panchanga) of Solanum xanthocarpum showed significant anti-tussive activity when compared to its roots. Administration of 10 gms of powder of drug for 10 days in 30 patients reported better action over [[kapha]] dominant kasa. The drug might be suppressing the central cough center by stimulating opioid receptors in the brain. It may be acting through protective ciliary activity in the respiratory tract. The action as demulcent can relieve cough.<ref name=mansukh>Mansukh S Parmar (2012): A comparative pharmacognostical, physicochemical and pharmacological study of moola and panchanga of Kantakari (Solanum xanthocarpum Schrad. & Wendl.) w.s.r. to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&RA, Jamnagar</ref>
The whole plant (panchanga) of Solanum xanthocarpum showed significant anti-tussive activity when compared to its roots. Administration of 10 gms of powder of drug for 10 days in 30 patients reported better action over [[kapha]] dominant kasa. The drug might be suppressing the central cough center by stimulating opioid receptors in the brain. It may be acting through protective ciliary activity in the respiratory tract. The action as demulcent can relieve cough.<ref name=mansukh>Mansukh S Parmar (2012): A comparative pharmacognostical, physicochemical and pharmacological study of moola and panchanga of Kantakari (Solanum xanthocarpum Schrad. & Wendl.) w.s.r. to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&RA, Jamnagar</ref>
=====Tribulus terrestris=====
An experimental study reported anti-tussive activity of root powder of Tribulus terrestris (laghu gokshura) in sulphur dioxide induced cough models. The number of cough episodes was significantly less in Tribulus terrestris (laghu gokshura) root administered group. While root of Pedalium murex (brihat gokshura) showed insignificant decrease in number of cough episodes. In a clinical study, administration of powder of Tribulus terrestris (laghu gokshura) root and root of Pedalium murex (brihat gokshura), 3gm twice a day in 28 patients of kasa is observed. It reported better effect in group administered with Tribulus terrestris. The effect was better in reducing [[vata]]kasa. This study also suggested effect of drug on central nervous system and its anti-inflammatory activity.<ref name=chandrika>Chandrika N Methekar (2012): A comparative pharmacognostical and phyto pharmacological assessment of moola, panchanga of laghu gokshura (Tribulus terrestris Linn.) and Brihat gokshura (Pedalium murex Linn.) w.s.r to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&RA, Jamanagar</ref>
An experimental study reported anti-tussive activity of root powder of Tribulus terrestris (laghu gokshura) in sulphur dioxide induced cough models. The number of cough episodes was significantly less in Tribulus terrestris (laghu gokshura) root administered group. While root of Pedalium murex (brihat gokshura) showed insignificant decrease in number of cough episodes. In a clinical study, administration of powder of Tribulus terrestris (laghu gokshura) root and root of Pedalium murex (brihat gokshura), 3gm twice a day in 28 patients of kasa is observed. It reported better effect in group administered with Tribulus terrestris. The effect was better in reducing [[vata]]kasa. This study also suggested effect of drug on central nervous system and its anti-inflammatory activity.<ref name=chandrika>Chandrika N Methekar (2012): A comparative pharmacognostical and phyto pharmacological assessment of moola, panchanga of laghu gokshura (Tribulus terrestris Linn.) and Brihat gokshura (Pedalium murex Linn.) w.s.r to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&RA, Jamanagar</ref>
=====Combination of terminalia chebula and rock salt=====
In a study conducted on 19 patients, Terminalia chebula (haritaki) with Rock salt (saindava lavana) was found effective in reducing the symptoms of [[kapha]]kasa. There was 92.3% relief in cough with sputum and itching in throat. The action of haritaki on [[vata]] and [[kapha]][[dosha]] due to its hot potency is observed as reason behind efficacy.<ref name=rout>Rout AK, Dwivedi RR. A clinical study of Haritaki and Saindhava Lavana in Kaphaja Kasa with special reference to Samyoga Guna. Ayu. 2011 Jul;32(3):357-60. doi: 10.4103/0974-8520.93914. PMID: 22736910; PMCID: PMC3326882.</ref>
In a study conducted on 19 patients, Terminalia chebula (haritaki) with Rock salt (saindava lavana) was found effective in reducing the symptoms of [[kapha]]kasa. There was 92.3% relief in cough with sputum and itching in throat. The action of haritaki on [[vata]] and [[kapha]][[dosha]] due to its hot potency is observed as reason behind efficacy.<ref name=rout>Rout AK, Dwivedi RR. A clinical study of Haritaki and Saindhava Lavana in Kaphaja Kasa with special reference to Samyoga Guna. Ayu. 2011 Jul;32(3):357-60. doi: 10.4103/0974-8520.93914. PMID: 22736910; PMCID: PMC3326882.</ref>
=====Kantakari-maricha leha=====
In a study, kantakari-marichaleha (ayurvedic formulation) was administered for 7 days in 30 children with symptoms of [[kapha]]kasa. It was found effective in reducing the signs and symptoms.<ref name=sawant>Sawant S, Nandgaonkar J A, Gujarathi R H. Efficacy of kantakari maricha leha on kaphaja kasa in children of age group 1 to 5 years. WJPR. 2018 Mar;7(7):1250-55. doi: 10.20959/wjpr20187-11693</ref>
In a study, kantakari-marichaleha (ayurvedic formulation) was administered for 7 days in 30 children with symptoms of [[kapha]]kasa. It was found effective in reducing the signs and symptoms.<ref name=sawant>Sawant S, Nandgaonkar J A, Gujarathi R H. Efficacy of kantakari maricha leha on kaphaja kasa in children of age group 1 to 5 years. WJPR. 2018 Mar;7(7):1250-55. doi: 10.20959/wjpr20187-11693</ref>
=====Samasharkara powder formulation=====
In another study on 60 patients with [[kapha]]kasa, 10gms of Samasarkarachurna for 15 days is found effective in reducing the signs and symptoms.<ref name=dighe>Dighe P M. Efficacy of Samsharkara Churna in Kaphaj Kasa. Ijam. 2013, 4(1), 36-42</ref>
In another study on 60 patients with [[kapha]]kasa, 10gms of Samasarkarachurna for 15 days is found effective in reducing the signs and symptoms.<ref name=dighe>Dighe P M. Efficacy of Samsharkara Churna in Kaphaj Kasa. Ijam. 2013, 4(1), 36-42</ref>
=====Bhrigarajasava as adjunct to anti tubercular treatment=====
In another study conducted on 60 patients with pulmonary tuberculosis (TB), administration of Bhrigarajasava along with the standard treatment was found effective in reducing the cough. The cough progressively diminished and became occasional and non-productive within 15 days of treatment.<ref>Dornala SN, Dornala SS. Clinical efficacy of Bhringarajasava as Naimittika Rasayana in Rajayakshma with special reference to pulmonary tuberculosis. Ayu. 2012 Oct;33(4):523-9. doi: 10.4103/0974-8520.110536. PMID: 23723670; PMCID: PMC3665204.</ref>
In another study conducted on 60 patients with pulmonary tuberculosis (TB), administration of Bhrigarajasava along with the standard treatment was found effective in reducing the cough. The cough progressively diminished and became occasional and non-productive within 15 days of treatment.<ref>Dornala SN, Dornala SS. Clinical efficacy of Bhringarajasava as Naimittika Rasayana in Rajayakshma with special reference to pulmonary tuberculosis. Ayu. 2012 Oct;33(4):523-9. doi: 10.4103/0974-8520.110536. PMID: 23723670; PMCID: PMC3665204.</ref>
=====Vyaghri-haritaki avaleha in chronic bronchitis=====
A study on 66 patients with chronic bronchitis reported that Vyaghri-haritaki avaleha effectively reduced the productive cough, which is the cardinal feature of chronic bronchitis.<ref>Ram J, Baghel MS. Clinical efficacy of Vyaghriharitaki Avaleha in the management of chronic bronchitis. Ayu. 2015 Jan-Mar;36(1):50-5. doi: 10.4103/0974-8520.169009. PMID: 26730139; PMCID: PMC4687240.</ref>
A study on 66 patients with chronic bronchitis reported that Vyaghri-haritaki avaleha effectively reduced the productive cough, which is the cardinal feature of chronic bronchitis.<ref>Ram J, Baghel MS. Clinical efficacy of Vyaghriharitaki Avaleha in the management of chronic bronchitis. Ayu. 2015 Jan-Mar;36(1):50-5. doi: 10.4103/0974-8520.169009. PMID: 26730139; PMCID: PMC4687240.</ref>
In another study conducted on 25 patients of kasa, administration of vyaghri-haritaki avaleha for four weeks showed highly significant results signs and symptoms.<ref>Suhas A. Chaudhary, Patel KS, Kori VK , Rajagopala S. Management of doshika kasa in subacute and chronic stage with Vyaghri haritaki avaleha in children. Ayurpharm Int J Ayur Alli Sci. 2014;3(4):97-111.</ref>
In another study conducted on 25 patients of kasa, administration of vyaghri-haritaki avaleha for four weeks showed highly significant results signs and symptoms.<ref>Suhas A. Chaudhary, Patel KS, Kori VK , Rajagopala S. Management of doshika kasa in subacute and chronic stage with Vyaghri haritaki avaleha in children. Ayurpharm Int J Ayur Alli Sci. 2014;3(4):97-111.</ref>
=====Unctuous enema in pertussis=====
Administration of unctuous enema (sneha[[basti]]) in pertussis patients of pediatric age group ( n=2) was studied. It was found very effective in reducing dry cough. Sesame oil in a dose of 10 - 20ml is used in [[basti]] for 14 days along with antimicrobial therapy. Initially, the intensity of cough was reduced, followed by a reduction in the frequency of cough episodes. Unctuous enema acts directly over the colon to restore normal functions of [[vata]][[dosha]].<ref>Gujarathi RH, Gokhale VM, Tongaonkar JN. Effect of Basti (oil enema) therapy for the management of cough in pertussis. Ayu. 2013 Oct;34(4):397-400. doi: 10.4103/0974-8520.127722. PMID: 24696577; PMCID: PMC3968703.</ref>
Administration of unctuous enema (sneha[[basti]]) in pertussis patients of pediatric age group ( n=2) was studied. It was found very effective in reducing dry cough. Sesame oil in a dose of 10 - 20ml is used in [[basti]] for 14 days along with antimicrobial therapy. Initially, the intensity of cough was reduced, followed by a reduction in the frequency of cough episodes. Unctuous enema acts directly over the colon to restore normal functions of [[vata]][[dosha]].<ref>Gujarathi RH, Gokhale VM, Tongaonkar JN. Effect of Basti (oil enema) therapy for the management of cough in pertussis. Ayu. 2013 Oct;34(4):397-400. doi: 10.4103/0974-8520.127722. PMID: 24696577; PMCID: PMC3968703.</ref>
=====Kasahara dashemani tablets=====
In 40 children with kasa, administration of Kasahara Dashemani vati for 60 days showed relief in all symptoms of kasa. Reduction in acute eosinophil count (AEC) and erythrocyte sedimentation rate (ESR) levels are noted. The decrease in IgE levels indicates the drug’s action against allergy. It is found effective in [[vata]] and [[pitta]] predominant kasa.<ref>Subrahmanya NK, Patel KS, Kori VK, Shrikrishna R. Role of Kasahara Dashemani Vati in Kasa and Vyadhikshamatva in children with special reference to recurrent respiratory tract infections. Ayu. 2013 Jul;34(3):281-7. doi: 10.4103/0974-8520.123124. PMID: 24501524; PMCID: PMC3902595.</ref>
In 40 children with kasa, administration of Kasahara Dashemani vati for 60 days showed relief in all symptoms of kasa. Reduction in acute eosinophil count (AEC) and erythrocyte sedimentation rate (ESR) levels are noted. The decrease in IgE levels indicates the drug’s action against allergy. It is found effective in [[vata]] and [[pitta]] predominant kasa.<ref>Subrahmanya NK, Patel KS, Kori VK, Shrikrishna R. Role of Kasahara Dashemani Vati in Kasa and Vyadhikshamatva in children with special reference to recurrent respiratory tract infections. Ayu. 2013 Jul;34(3):281-7. doi: 10.4103/0974-8520.123124. PMID: 24501524; PMCID: PMC3902595.</ref>
== List of research works done ==
=== List of research works done ===
#Mansukh S Parmar (2012): A comparative pharmacognostical, physicochemical and pharmacological study of moola and panchanga of Kantakari (Solanum xanthocarpum Schrad. & Wendl.) w.s.r. to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&RA, Jamnagar
#Mansukh S Parmar (2012): A comparative pharmacognostical, physicochemical and pharmacological study of moola and panchanga of Kantakari (Solanum xanthocarpum Schrad. & Wendl.) w.s.r. to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&RA, Jamnagar
#Chandrika N Methekar (2012): A comparative pharmacognostical and phyto pharmacological assessment of moola, panchanga of laghugokshura (Tribulus terrestris Linn.) and Brihatgokshura (Pedalium murex Linn.) w.s.r to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&RA, Jamanagar
#Chandrika N Methekar (2012): A comparative pharmacognostical and phyto pharmacological assessment of moola, panchanga of laghugokshura (Tribulus terrestris Linn.) and Brihatgokshura (Pedalium murex Linn.) w.s.r to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&RA, Jamanagar
== Abbreviations ==
=== Abbreviations ===
Cha. = Charak, Su. = Sushruta, A. = Ashtanga, Hr. = Hridayam, Sa. = Samhita, B.R = Bhaishajya ratnavali
Cha. = Charak, Su. = Sushruta, A. = Ashtanga, Hr. = Hridayam, Sa. = Samhita, B.R = Bhaishajya ratnavali
== References ==
=== References ===